POS1458 HOW EASY IS IT FOR PATIENTS TO READ AND UNDERSTAND AVAILABLE PATIENT EDUCATIONAL MATERIALS FOR LUPUS?
Authors: U. C. Nweke, S. Hassan, J. Meenakshi
Journal: Annals of the Rheumatic Diseases (2022)

Background Health Literacy (HL) informs health behaviors such as follow-up with health care providers &amp; management plans. Poor HL is linked to poor health outcomes &amp; healthcare disparity. In addition to personal HL, health care providers/systems &amp; Organizations can also empower patients by developing &amp; providing educational resources that foster HL &amp; support a patient’s understanding of their health condition (organizational HL). Patient educational handouts are frequently provided after a physician visit to supplement instructions/education &amp; are often obtained from online resources accessible to both physicians &amp; patients. Lupus, a multisystem disease, preferentially effects people of color, a group at higher risk of health disparities, &amp; poor HL. It is paramount for lupus patients to understand their disease &amp; management to optimize health outcomes &amp; reduce health disparities. The provision of easy to read &amp; comprehend patient educational resources are one way to address this need. Objectives The Center for Disease Control (CDC) recommends the readability of patient educational material to be at eight-grade level, while the National Institute of Health (NIH) &amp; the American Medical Association (AMA) recommend a level no higher than sixth-grade. The Readability &amp; Comprehension (RC) of commonly available lupus-related patient educational materials are not known &amp; may offer an opportunity to improve patient care &amp; outcomes. Methods We searched for the RC of Lupus-related patient educational materials, available at the American College of Rheumatology (ACR) &amp; Lupus Foundation of America (LFA) websites. These reputable national organizations are at the forefront of Lupus education &amp; research. RC were evaluated using the following measures: Flesch Kincaid Readability Ease (FKRE), Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GFS), Simple Measure of Gobbledygook (SMOG) Index, Coleman Liau Index (CLI) &amp; Automated Readability Index (ARI). FKRE score is a widely used measure of readability with scores ranging from 0-100 &amp; higher scores denoting greater reading ease (Goal is &gt;60). FKGL represents the U.S. school grade needed to comprehend the text (Target is 7 th grade). GFS estimates the years of formal education required to understand the text on the first reading (Goal is 7-8). SMOG index estimates the years of education needed to comprehend written materials. CLI is used to assess the U.S. grade level necessary to comprehend text material. The ARI assesses how easy a text material is to learn &amp; estimates the U.S. grade level necessary to comprehend a passage. Descriptives for RC were obtained &amp; compared using t test between the two sources. Results There were 12 patient educational pamphlets on Lupus available (4 from ACR &amp; 8 from LFA). Mean (SD) FKRE &amp; FKGL were 52.73 (11.44) &amp; 10.46 (2.14) respectively (Table 1). Mean GFS &amp; CLI exceeded 12, while mean ARI was 18. Table 1. Reading &amp; Comprehension of Patient Educational Materials on Lupus RC Test (Values are Mean (SD)) All ACR LFA P Flesch Kincaid Reading Ease 52.73 47.18 55.50 0.25 (11.44) (4.93) (13.00) Flesch Kincaid Grade Level 10.46 10.73 10.33 0.78 (2.14) (0.64) (2.64) Gunning Fog Score 12.19 12.65 11.96 0.41 (1.78) (0.31) (2.19) SMOG Index 8.94 9.6 8.61 0.27 (1.41) (0.67) (1.60) Coleman Liau Index 13.51 14.65 12.94 0.18 (2.04) (1.34) (2.15) Automated Readability Index 18.02 11.1 21.47 0.49 (23.13) (1.45) (28.27) There were no significant differences in the RC scores among patient educational materials from the ACR or LFA. Conclusion Patient educational materials on Lupus, available at the ACR &amp; LFA websites, are not easy to read or comprehend, using standardized RC metrics. Additionally, they are not aligned with recommended reading levels suggested by leading organizations (CDC, NIH or AMA). Patient’s understanding is critical in a complex disease like lupus to optimize health outcomes. Revision of patient lupus educational resources at these websites, to target 6-7 th grade RC metrics, is recommended &amp; could be overseen by the development of a new taskforce. Disclosure of Interests None declared